Individual provider Active NPI

Hannah Rose Rugg, MD

  • Pediatrics Physician
  • Ruston, LA
National Provider Identifier
1831758630
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
331414 Issued in LA
Practice address
1200 S Farmerville St
Ruston, LA 71270-5941
Phone
(318) 251-6240
Fax
(318) 251-6136
NPI assigned
Jun 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X LL82702 SC
Pediatrics Physician 208000000X 331414 LA Primary

Addresses

Primary practice location

1200 S Farmerville St
Ruston, LA 71270-5941

Mailing address

Children'S Hospital Outpatient Center
14 Medical Park, Ste 400
Columbia, SC 29203
Phone (803) 434-6155

Other practice location 1

Children's Hospital Outpatient Center
14 Medical Park, Ste 400
Columbia, SC 29203
Phone (803) 434-6155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220726000254 LA Practitioner - Pediatric Medicine 0244662161 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Louisiana State University School of Medicine in New Orleans, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Green Clinic LLC 29 clinicians

Practice addresses (Care Compare)

1200 S Farmerville St
Ruston, LA 71270-5941
Phone (318) 255-3690

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Green Clinic LLC Pediatrics CurrentSince Jul 15, 2022 Accepting new patients
CLHG-Ruston LLC CurrentSince Dec 1, 2025 Accepting new patients
Green Clinic LLC CurrentSince Jul 15, 2022 Accepting new patients
CLHG-Ruston LLC CurrentSince Dec 1, 2025 Accepting new patients

Locations

1809 Northpointe Ln
Ste 102
Ruston, LA 71270
Phone (318) 255-3762

411 E Vaughn Ave
Ste 104
Ruston, LA 71270
Phone (318) 254-2453

401 E Vaughn Ave
Ruston, LA 71270
Phone (318) 254-2100

1200 S Farmerville St
Ruston, LA 71270
Phone (318) 251-6103

Interoperability endpoints

  • Direct secure messaging: hannah.rugg.1@26990.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1831758630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CHILDREN'S HOSPITAL OUTPATIENT CENTER",
            "address_2": "14 MEDICAL PARK, STE 400",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "803-434-6155",
            "fax_number": "803-434-6979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S FARMERVILLE ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705941",
            "telephone_number": "318-251-6240",
            "fax_number": "318-251-6136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Children's Hospital Outpatient Center",
            "address_2": "14 Medical Park, Ste 400",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "29203",
            "country_code": "US",
            "telephone_number": "803-434-6155",
            "fax_number": "803-434-6979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUGG",
        "first_name": "HANNAH",
        "middle_name": "ROSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-06",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "LL82702",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "331414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruston, LA

Sources for this page

Verify at the official NPI Registry.